Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed

ABSTRACT

An end effector for use with a surgical instrument. The end effector includes first and second jaws that are pivotally coupled together and configured to touch at their respective distal ends when fully closed.

BACKGROUND

The present invention relates to surgical instruments and, in variousarrangements, to surgical stapling and cutting instruments and staplecartridges for use therewith that are designed to staple and cut tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is a perspective view of an electromechanical surgical system;

FIG. 2 is a perspective view of a distal end of an electromechanicalsurgical instrument portion of the surgical system of FIG. 1;

FIG. 3 is an exploded assembly view of an outer shell feature and theelectromechanical surgical instrument of FIG. 2;

FIG. 4 is a rear perspective view of a portion of the electromechanicalsurgical instrument of FIG. 2;

FIG. 5 is a partial exploded assembly view of a portion of an adapterand the electromechanical surgical instrument of the surgical system ofFIG. 1;

FIG. 6 is an exploded assembly view of a portion of the adapter of FIG.5;

FIG. 7 is a cross-sectional perspective view of a portion of anarticulation assembly of an adapter;

FIG. 8 is a perspective view of the articulation assembly of FIG. 7;

FIG. 9 is another perspective view of the articulation assembly of FIG.8;

FIG. 10 is an exploded assembly view of a loading unit employed in theelectromechanical surgical system of FIG. 1;

FIG. 11 is a perspective view of an alternative adapter embodiment;

FIG. 12 is a side elevational view of a portion of a loading unit of theadapter of FIG. 11 with the jaws thereof in an open position;

FIG. 13 is another side elevational view of a portion of the loadingunit of FIG. 11 with portions thereof shown in cross-section and thejaws thereof in a closed position;

FIG. 14 is a bottom view of a portion of the loading unit of FIG. 13with portions thereof shown in cross-section;

FIG. 15 is a perspective view of a portion of the loading unit of FIG.14 with a portion of the outer tube shown in phantom lines;

FIG. 16 is a cross-sectional view of a proximal portion of anotheradapter employing various seal arrangements therein;

FIG. 17 is an end cross-sectional view of a portion of the adapter ofFIG. 16;

FIG. 18 is a side elevation al view of another adapter;

FIG. 19 is a cross-sectional view of a portion of the adapter of FIG.18;

FIG. 20 is a rear perspective view of portions of another adapter;

FIG. 21 is a cross-sectional view of another adapter;

FIG. 22 is a partial cross-sectional view of a loading unit toolassembly of another adapter with the jaws thereof in a fully openposition;

FIG. 23 is another a partial cross-sectional view of the loading unittool assembly of FIG. 22 with the jaws thereof in a closed position;

FIG. 24 is another a partial cross-sectional view of the loading unittool assembly of FIGS. 22 and 23 with a dynamic clamping assemblythereof at the end of a closing stroke and the jaws thereof in a fullyclosed position; and

FIG. 25 is another partial cross-sectional view of the loading unit toolassembly of FIGS. 22-24 with the dynamic clamping assembly thereofapproaching the end of a firing stroke.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. PatentApplications that were filed on Dec. 15, 2017 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 15/843,485, entitled SEALED        ADAPTERS FOR USE WITH ELECTROMECHANICAL SURGICAL INSTRUMENTS,        now U.S. Patent Application Publication No. 2019/0183492;    -   U.S. patent application Ser. No. 15/843,518, entitled END        EFFECTORS WITH POSITIVE JAW OPENING FEATURES FOR USE WITH        ADAPTERS FOR ELECTROMECHANICAL SURGICAL INSTRUMENTS, now U.S.        Patent Application Publication No. 2019/0183496;    -   U.S. patent application Ser. No. 15/843,535, entitled SURGICAL        END EFFECTORS WITH CLAMPING ASSEMBLIES CONFIGURED TO INCREASE        JAW APERTURE RANGES, now U.S. Patent Application Publication No.        2019/0183498;    -   U.S. patent application Ser. No. 15/843,528, entitled SURGICAL        END EFFECTORS WITH JAW STIFFENER ARRANGEMENTS CONFIGURED TO        PERMIT MONITORING OF FIRING MEMBER, now U.S. Patent Application        Publication No. 2019/0183497;    -   U.S. patent application Ser. No. 15/843,567, entitled ADAPTERS        WITH END EFFECTOR POSITION SENSING AND CONTROL ARRANGEMENTS FOR        USE IN CONNECTION WITH ELECTROMECHANICAL SURGICAL INSTRUMENTS,        now U.S. Patent Application Publication No. 2019/0183500;    -   U.S. patent application Ser. No. 15/843,556, entitled DYNAMIC        CLAMPING ASSEMBLIES WITH IMPROVED WEAR CHARACTERISTICS FOR USE        IN CONNECTION WITH ELECTROMECHANICAL SURGICAL INSTRUMENTS, now        U.S. Patent Application Publication No. 2019/0183490;    -   U.S. patent application Ser. No. 15/843,514, entitled ADAPTERS        WITH FIRING STROKE SENSING ARRANGEMENTS FOR USE IN CONNECTION        WITH ELECTROMECHANICAL SURGICAL INSTRUMENTS, now U.S. patent        application Publication

No. 2019-0183495;

-   -   U.S. patent application Ser. No. 15/843,501, entitled ADAPTERS        WITH CONTROL SYSTEMS FOR CONTROLLING MULTIPLE MOTORS OF AN        ELECTROMECHANICAL SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2019/0183493;    -   U.S. patent application Ser. No. 15/843,508, entitled HANDHELD        ELECTROMECHANICAL SURGICAL INSTRUMENTS WITH IMPROVED MOTOR        CONTROL ARRANGEMENTS FOR POSITIONING COMPONENTS OF AN ADAPTER        COUPLED THERETO, now U.S. Patent Application Publication No.        2019/0183494;    -   U.S. patent application Ser. No. 15/843,682, entitled SYSTEMS        AND METHODS OF CONTROLLING A CLAMPING MEMBER FIRING RATE OF A        SURGICAL INSTRUMENT, now U.S. Patent Application Publication No.        2019/0183501;    -   U.S. patent application Ser. No. 15/843,689, entitled SYSTEMS        AND METHODS OF CONTROLLING A CLAMPING MEMBER, now U.S. Patent        Application Publication No. 2019/0183502; and    -   U.S. patent application Ser. No. 15/843,704, entitled METHODS OF        OPERATING SURGICAL END EFFECTORS, now U.S. Patent Application        Publication No. 2019/0183503.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

A surgical stapling system can comprise a shaft and an end effectorextending from the shaft. The end effector comprises a first jaw and asecond jaw. The first jaw comprises a staple cartridge. The staplecartridge is insertable into and removable from the first jaw; however,other embodiments are envisioned in which a staple cartridge is notremovable from, or at least readily replaceable from, the first jaw. Thesecond jaw comprises an anvil configured to deform staples ejected fromthe staple cartridge. The second jaw is pivotable relative to the firstjaw about a closure axis; however, other embodiments are envisioned inwhich the first jaw is pivotable relative to the second jaw. Thesurgical stapling system further comprises an articulation jointconfigured to permit the end effector to be rotated, or articulated,relative to the shaft. The end effector is rotatable about anarticulation axis extending through the articulation joint. Otherembodiments are envisioned which do not include an articulation joint.

The staple cartridge comprises a cartridge body. The cartridge bodyincludes a proximal end, a distal end, and a deck extending between theproximal end and the distal end. In use, the staple cartridge ispositioned on a first side of the tissue to be stapled and the anvil ispositioned on a second side of the tissue. The anvil is moved toward thestaple cartridge to compress and clamp the tissue against the deck.Thereafter, staples removably stored in the cartridge body can bedeployed into the tissue. The cartridge body includes staple cavitiesdefined therein wherein staples are removably stored in the staplecavities. The staple cavities are arranged in six longitudinal rows.Three rows of staple cavities are positioned on a first side of alongitudinal slot and three rows of staple cavities are positioned on asecond side of the longitudinal slot. Other arrangements of staplecavities and staples may be possible.

The staples are supported by staple drivers in the cartridge body. Thedrivers are movable between a first, or unfired position, and a second,or fired, position to eject the staples from the staple cavities. Thedrivers are retained in the cartridge body by a retainer which extendsaround the bottom of the cartridge body and includes resilient membersconfigured to grip the cartridge body and hold the retainer to thecartridge body. The drivers are movable between their unfired positionsand their fired positions by a sled. The sled is movable between aproximal position adjacent the proximal end and a distal positionadjacent the distal end. The sled comprises a plurality of rampedsurfaces configured to slide under the drivers and lift the drivers, andthe staples supported thereon, toward the anvil.

Further to the above, the sled is moved distally by a firing member. Thefiring member is configured to contact the sled and push the sled towardthe distal end. The longitudinal slot defined in the cartridge body isconfigured to receive the firing member. The anvil also includes a slotconfigured to receive the firing member. The firing member furthercomprises a first cam which engages the first jaw and a second cam whichengages the second jaw. As the firing member is advanced distally, thefirst cam and the second cam can control the distance, or tissue gap,between the deck of the staple cartridge and the anvil. The firingmember also comprises a knife configured to incise the tissue capturedintermediate the staple cartridge and the anvil. It is desirable for theknife to be positioned at least partially proximal to the rampedsurfaces such that the staples are ejected ahead of the knife.

FIG. 1 depicts a motor-driven (electromechanical) surgical system 1 thatmay be used to perform a variety of different surgical procedures. Ascan be seen in that Figure, one example of the surgical system 1includes a powered handheld electromechanical surgical instrument 100that is configured for selective attachment thereto of a plurality ofdifferent surgical tool implements (referred to herein as “adapters”)that are each configured for actuation and manipulation by the poweredhandheld electromechanical surgical instrument. As illustrated in FIG.1, the handheld surgical instrument 100 is configured for selectiveconnection with an adapter 200, and, in turn, adapter 200 is configuredfor selective connection with end effectors that comprise a single useloading unit (“SULU”) or a disposable loading unit (“DLU”) or a multipleuse loading unit (“MULU”). In another surgical system embodiment,various forms of adapter 200 may also be effectively employed with atool drive assembly of a robotically controlled or automated surgicalsystem. For example, the surgical tool assemblies disclosed herein maybe employed with various robotic systems, instruments, components andmethods such as, but not limited to, those disclosed in U.S. Pat. No.9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS, which is hereby incorporated by referenceherein in its entirety.

As illustrated in FIGS. 1 and 2, surgical instrument 100 includes apower-pack 101 and an outer shell housing 10 that is configured toselectively receive and substantially encase the power-pack 101. Thepower pack 101 may also be referred to herein as handle assembly 101.One form of surgical instrument 100, for example, is disclosed inInternational Publication No. WO 2016/057225 A1, InternationalApplication No. PCT/US2015/051837, entitled HANDHELD ELECTROMECHANICALSURGICAL SYSTEM, the entire disclosure of which is hereby incorporatedby reference herein. Various features of surgical instrument 100 willnot be disclosed herein beyond what is necessary to understand thevarious features of the inventions disclosed herein with it beingunderstood that further details may be gleaned from reference to WO2016/057225 A1 and other references incorporated by reference herein.

As illustrated in FIG. 3, outer shell housing 10 includes a distalhalf-section 10 a and a proximal half-section 10 b that is pivotablyconnected to distal half-section 10 a by a hinge 16 located along anupper edge of distal half-section 10 a and proximal half-section 10 b.When joined, distal and proximal half-sections 10 a, 10 b define a shellcavity 10 c therein in which the power-pack 101 is selectively situated.Each of distal and proximal half-sections 10 a, 10 b includes arespective upper shell portion 12 a, 12 b, and a respective lower shellportion 14 a, 14 b. Lower shell portions 14 a, 14 b define a snapclosure feature 18 for selectively securing the lower shell portions 14a, 14 b to one another and for maintaining shell housing 10 in a closedcondition. Distal half-section 10 a of shell housing 10 defines aconnecting portion 20 that is configured to accept a corresponding drivecoupling assembly 210 of adapter 200 (see FIG. 5). Specifically, distalhalf-section 10 a of shell housing 10 has a recess that receives aportion of drive coupling assembly 210 of adapter 200 when adapter 200is mated to surgical instrument 100.

Connecting portion 20 of distal half-section 10 a defines a pair ofaxially extending guide rails 21 a, 21 b that project radially inwardfrom inner side surfaces thereof as shown in FIG. 5. Guide rails 21 a,21 b assist in rotationally orienting adapter 200 relative to surgicalinstrument 100 when adapter 200 is mated to surgical instrument 100.Connecting portion 20 of distal half-section 10 a defines threeapertures 22 a, 22 b, 22 c that are formed in a distally facing surfacethereof and which are arranged in a common plane or line with oneanother. Connecting portion 20 of distal half-section 10 a also definesan elongate slot 24 also formed in the distally facing surface thereof.Connecting portion 20 of distal half-section 10 a further defines afemale connecting feature 26 (see FIG. 2) formed in a surface thereof.Female connecting feature 26 selectively engages with a male connectingfeature of adapter 200.

Distal half-section 10 a of shell housing 10 supports a distal facingtoggle control button 30. The toggle control button 30 is capable ofbeing actuated in a left, right, up and down direction upon applicationof a corresponding force thereto or a depressive force thereto. Distalhalf-section 10 a of shell housing 10 supports a right-side pair ofcontrol buttons 32 a, 32 b (see FIG. 3); and a left-side pair of controlbutton 34 a, 34 b (see FIG. 2). The right-side control buttons 32 a, 32b and the left-side control buttons 34 a, 34 b are capable of beingactuated upon application of a corresponding force thereto or adepressive force thereto. Proximal half-section 10 b of shell housing 10supports a right-side control button 36 a (see FIG. 3) and a left-sidecontrol button 36 b (see FIG. 2). Right-side control button 36 a andleft-side control button 36 b are capable of being actuated uponapplication of a corresponding force thereto or a depressive forcethereto.

Shell housing 10 includes a sterile barrier plate assembly 60selectively supported in distal half-section 10 a. Specifically, thesterile barrier plate assembly 60 is disposed behind connecting portion20 of distal half-section 10 a and within shell cavity 10 c of shellhousing 10. The plate assembly 60 includes a plate 62 rotatablysupporting three coupling shafts 64 a, 64 b, 64 c (see FIGS. 3 and 5).Each coupling shaft 64 a, 64 b, 64 c extends from opposed sides of plate62 and has a tri-lobe transverse cross-sectional profile. Each couplingshaft 64 a, 64 b, 64 c extends through the respective apertures 22 a, 22b, 22 c of connecting portion 20 of distal half-section 10 a when thesterile barrier plate assembly 60 is disposed within shell cavity 10 cof shell housing 10. The plate assembly 60 further includes anelectrical pass-through connector 66 supported on plate 62. Pass-throughconnector 66 extends from opposed sides of plate 62. Pass-throughconnector 66 defines a plurality of contact paths each including anelectrical conduit for extending an electrical connection across plate62. When the plate assembly 60 is disposed within shell cavity 10 c ofshell housing 10, distal ends of coupling shaft 64 a, 64 b, 64 c and adistal end of pass-through connector 66 are disposed or situated withinconnecting portion 20 of distal half-section 10 a of shell housing 10,and are configured to electrically and/or mechanically engage respectivecorresponding features of adapter 200.

Referring to FIGS. 3 and 4, the power-pack or the handle assembly 101includes an inner handle housing 110 having a lower housing portion 104and an upper housing portion 108 extending from and/or supported onlower housing portion 104. Lower housing portion 104 and upper housingportion 108 are separated into a distal half section 110 a and aproximal half-section 110 b connectable to distal half-section 110 a bya plurality of fasteners. When joined, distal and proximal half-sections110 a, 110 b define the inner handle housing 110 having an inner housingcavity 110 c therein in which a power-pack core assembly 106 issituated. Power-pack core assembly 106 is configured to control thevarious operations of surgical instrument 100.

Distal half-section 110 a of inner handle housing 110 supports a distaltoggle control interface 130 that is in operative registration with thedistal toggle control button 30 of shell housing 10. In use, when thepower-pack 101 is disposed within shell housing 10, actuation of thetoggle control button 30 exerts a force on toggle control interface 130.Distal half-section 110 a of inner handle housing 110 also supports aright-side pair of control interfaces (not shown), and a left-side pairof control interfaces 132 a, 132 b. In use, when the power-pack 101 isdisposed within shell housing 10, actuation of one of the right-sidepair of control buttons or the left-side pair of control button ofdistal half-section 10 a of shell housing 10 exerts a force on arespective one of the right-side pair of control interfaces 132 a, 132 bor the left-side pair of control interfaces 132 a, 132 b of distalhalf-section 110 a of inner handle housing 110.

With reference to FIGS. 1-5, inner handle housing 110 provides a housingin which power-pack core assembly 106 is situated. Power-pack coreassembly 106 includes a battery circuit 140, a controller circuit board142 and a rechargeable battery 144 configured to supply power to any ofthe electrical components of surgical instrument 100. Controller circuitboard 142 includes a motor controller circuit board 142 a, a maincontroller circuit board 142 b, and a first ribbon cable 142 cinterconnecting motor controller circuit board 142 a and main controllercircuit board 142 b. Power-pack core assembly 106 further includes adisplay screen 146 supported on main controller circuit board 142 b.Display screen 146 is visible through a clear or transparent window 110d (see FIG. 3) provided in proximal half-section 110 b of inner handlehousing 110. It is contemplated that at least a portion of inner handlehousing 110 may be fabricated from a transparent rigid plastic or thelike. It is further contemplated that shell housing 10 may eitherinclude a window formed therein (in visual registration with displayscreen 146 and with window 110 d of proximal half-section 110 b of innerhandle housing 110, and/or shell housing 10 may be fabricated from atransparent rigid plastic or the like.

Power-pack core assembly 106 further includes a first motor 152, asecond motor 154, and a third motor 156 that are supported by motorbracket 148 and are each electrically connected to controller circuitboard 142 and battery 144. Motors 152, 154, 156 are disposed betweenmotor controller circuit board 142 a and main controller circuit board142 b. Each motor 152, 154, 156 includes a respective motor shaft 152 a,154 a, 156 a extending therefrom. Each motor shaft 152 a, 154 a, 156 ahas a tri-lobe transverse cross-sectional profile for transmittingrotative forces or torque. Each motor 152, 154, 156 is controlled by arespective motor controller. Rotation of motor shafts 152 a, 154 a, 156a by respective motors 152, 154, 156 function to drive shafts and/orgear components of adapter 200 in order to perform the variousoperations of surgical instrument 100. In particular, motors 152, 154,156 of power-pack core assembly 106 are configured to drive shaftsand/or gear components of adapter 200.

As illustrated in FIGS. 1 and 5, surgical instrument 100 is configuredfor selective connection with adapter 200, and, in turn, adapter 200 isconfigured for selective connection with end effector 500. Adapter 200includes an outer knob housing 202 and an outer tube 206 that extendsfrom a distal end of knob housing 202. Knob housing 202 and outer tube206 are configured and dimensioned to house the components of adapterassembly 200. Outer tube 206 is dimensioned for endoscopic insertion, inparticular, that outer tube is passable through a typical trocar port,cannula or the like. Knob housing 202 is dimensioned to not enter thetrocar port, cannula of the like. Knob housing 202 is configured andadapted to connect to connecting portion 20 of the outer shell housing10 of surgical instrument 100.

Adapter 200 is configured to convert a rotation of either of first orsecond coupling shafts 64 a, 64 b of surgical instrument 100 into axialtranslation useful for operating a drive assembly 540 and anarticulation link 560 of end effector 500, as illustrated in FIG. 10 andas will be described in greater detail below. As illustrated in FIG. 6,adapter 200 includes the proximal inner housing assembly 204 thatrotatably supports a first rotatable proximal drive shaft 212, a secondrotatable proximal drive shaft 214, and a third rotatable proximal driveshaft 216 therein. Each proximal drive shaft 212, 214, 216 functions asa rotation receiving member to receive rotational forces from respectivecoupling shafts 64 a, 64 b and 64 c of surgical instrument 100. Inaddition, the drive coupling assembly 210 of adapter 200 is alsoconfigured to rotatably support first, second and third connectorsleeves 218, 220 and 222, respectively, arranged in a common plane orline with one another. Each connector sleeve 218, 220, 222 is configuredto mate with respective first, second and third coupling shafts 64 a, 64b, 64 c of surgical instrument 100, as described above. Each connectorsleeves 218, 222, 220 is further configured to mate with a proximal endof respective first, second, and third proximal drive shafts 212, 214,216 of adapter 200.

Drive coupling assembly 210 of adapter 200 also includes a first, asecond, and a third biasing member 224, 226, and 228 disposed distallyof respective first, second, and third connector sleeves 218, 220, 222.Each biasing members 224, 226, and 228 is disposed about respectivefirst, second, and third rotatable proximal drive shaft 212, 214, and216. Biasing members 224, 226, and 228 act on respective connectorsleeves 218, 222, and 220 to help maintain connector sleeves 218, 222,and 220 engaged with the distal end of respective coupling shafts 64 a,64 b, and 64 c of surgical instrument 100 when adapter 200 is connectedto surgical instrument 100.

Also in the illustrated arrangement, adapter 200 includes first, second,and third drive converting assemblies 240, 250, 260, respectively, thatare each disposed within inner housing assembly 204 and outer tube 206.Each drive converting assembly 240, 250, 260 is configured and adaptedto transmit or convert a rotation of a first, second, and third couplingshafts 64 a, 64 b, and 64 c of surgical instrument 100 into axialtranslation of an articulation driver or bar 258 of adapter 200, toeffectuate articulation of end effector 500; a rotation of a ring gear266 of adapter 200, to effectuate rotation of adapter 200; or axialtranslation of a distal drive member 248 of adapter 200 to effectuateclosing, opening, and firing of end effector 500.

Still referring to FIG. 6, first force/rotation transmitting/convertingassembly 240 includes first rotatable proximal drive shaft 212, which,as described above, is rotatably supported within inner housing assembly204. First rotatable proximal drive shaft 212 includes a non-circular orshaped proximal end portion configured for connection with firstconnector sleeve 218 which is connected to respective first couplingshaft 64 a of surgical instrument 100. First rotatable proximal driveshaft 212 includes a threaded distal end portion 212 b. Firstforce/rotation transmitting/converting assembly 240 further includes adrive coupling nut 244 that threadably engages the threaded distal endportion 212 b of first rotatable proximal drive shaft 212, and which isslidably disposed within outer tube 206. Drive coupling nut 244 isslidably keyed within proximal core tube portion of outer tube 206 so asto be prevented from rotation as first rotatable proximal drive shaft212 is rotated. In this manner, as the first rotatable proximal driveshaft 212 is rotated, drive coupling nut 244 is translated alongthreaded distal end portion 212 b of first rotatable proximal driveshaft 212 and, in turn, through and/or along outer tube 206.

First force/rotation transmitting/converting assembly 240 furtherincludes a distal drive member 248 that is mechanically engaged withdrive coupling nut 244, such that axial movement of drive coupling nut244 results in a corresponding amount of axial movement of distal drivemember 248. The distal end portion of distal drive member 248 supports aconnection member 247 configured and dimensioned for selectiveengagement with an engagement member 546 of a drive assembly 540 of endeffector 500 (FIG. 10). Drive coupling nut 244 and/or distal drivemember 248 function as a force transmitting member to components of endeffector 500. In operation, as first rotatable proximal drive shaft 212is rotated, as a result of the rotation of first coupling shaft 64 a ofsurgical instrument 100, drive coupling nut 244 is translated axiallyalong first rotatable proximal drive shaft 212. As drive coupling nut244 is translated axially along first rotatable proximal drive shaft212, distal drive member 248 is translated axially relative to outertube 206. As distal drive member 248 is translated axially, withconnection member 247 connected thereto and engaged with a hollow drivemember 548 attached to drive assembly 540 of end effector 500 (FIG. 10),distal drive member 248 causes concomitant axial translation of driveassembly 540 of end effector 500 to effectuate a closure of a toolassembly portion 600 of the end effector 500 and a firing of variouscomponents within the tool assembly.

Still referring to FIG. 6, second drive converting assembly 250 ofadapter 200 includes second proximal drive shaft 214 that is rotatablysupported within inner housing assembly 204. Second rotatable proximaldrive shaft 214 includes a non-circular or shaped proximal end portionconfigured for connection with second coupling shaft 64 c of surgicalinstrument 100. Second rotatable proximal drive shaft 214 furtherincludes a threaded distal end portion 214 a configured to threadablyengage an articulation bearing housing 253 of an articulation bearingassembly 252. Referring to FIGS. 6-9, the articulation bearing housing253 supports an articulation bearing 255 that has an inner race 257 thatis independently rotatable relative to an outer race 259. Articulationbearing housing 253 has a non-circular outer profile, for exampletear-dropped shaped, that is slidably and non-rotatably disposed withina complementary bore (not shown) of inner housing hub 204 a. Seconddrive converting assembly 250 of adapter 200 further includesarticulation bar 258 that has a proximal portion that is secured toinner race 257 of articulation bearing 255. A distal portion ofarticulation bar 258 includes a slot 258 a therein, which is configuredto accept a hook 562 the articulation link 560 (FIG. 10) of end effector500. Articulation bar 258 functions as a force transmitting member tocomponents of end effector 500. In the illustrated arrangement and asfurther discussed in WO 2016/057225 A1, articulation bearing assembly252 is both rotatable and longitudinally translatable and is configuredto permit free, unimpeded rotational movement of end effector 500 whenits first and second jaw members 610, 700 are in an approximatedposition and/or when jaw members 610, 700 are articulated.

In operation, as second proximal drive shaft 214 is rotated, thearticulation bearing assembly 252 is axially translated along threadeddistal end portion 214 a of second proximal drive shaft 214, which inturn, causes articulation bar 258 to be axially translated relative toouter tube 206. As articulation bar 258 is translated axially,articulation bar 258, being coupled to articulation link 560 of endeffector 500, causes concomitant axial translation of articulation link560 of end effector 500 to effectuate an articulation of tool assembly600. Articulation bar 258 is secured to inner race 257 of articulationbearing 253 and is thus free to rotate about the longitudinal axisrelative to outer race 259 of articulation bearing 253.

As illustrated in FIG. 6, adapter 200 includes a third drive convertingassembly 260 that is supported in inner housing assembly 204. Thirddrive converting assembly 260 includes rotation ring gear 266 that isfixedly supported in and connected to outer knob housing 202. Ring gear266 defines an internal array of gear teeth 266 a and includes a pair ofdiametrically opposed, radially extending protrusions 266 b. Protrusions266 b are configured to be disposed within recesses defined in outerknob housing 202, such that rotation of ring gear 266 results inrotation of outer knob housing 202, and vice a versa. Third driveconverting assembly 260 further includes third rotatable proximal driveshaft 216 which, as described above, is rotatably supported within innerhousing assembly 204. Third rotatable proximal drive shaft 216 includesa non-circular or shaped proximal end portion that is configured forconnection with third connector 220. Third rotatable proximal driveshaft 216 includes a spur gear 216 keyed to a distal end thereof. Areversing spur gear 264 inter-engages spur gear 216 a of third rotatableproximal drive shaft 216 to gear teeth 266 a of ring gear 266. Inoperation, as third rotatable proximal drive shaft 216 is rotated, dueto a rotation of the third coupling shaft 64 b of surgical instrument100, spur gear 216 a of third rotatable proximal drive shaft 216 engagesreversing gear 264 causing reversing gear 264 to rotate. As reversinggear 264 rotates, ring gear 266 also rotates thereby causing outer knobhousing 202 to rotate. Rotation of the outer knob housing 202 causes theouter tube 206 to rotate about longitudinal axis of adapter 200. Asouter tube 206 is rotated, end effector 500 that is connected to adistal end portion of adapter 200, is also rotated about a longitudinalaxis of adapter 200.

Adapter 200 further includes an attachment/detachment button 272 (FIG.5) that is supported on a stem 273 (FIG. 6) that projects from drivecoupling assembly 210 of adapter 200. The attachment/detachment button272 is biased by a biasing member (not shown) that is disposed within oraround stem 273, to an un-actuated condition. Button 272 includes a lipor ledge that is configured to snap behind a corresponding lip or ledgeof connecting portion 20 of the surgical instrument 100. As alsodiscussed in WO 2016/057225 A1, the adapter 200 may further include alock mechanism 280 for fixing the axial position of distal drive member248. As can be seen in FIG. 21, for example, lock mechanism 280 includesa button 282 that is slidably supported on outer knob housing 202. Lockbutton 282 is connected to an actuation bar (not shown) that extendslongitudinally through outer tube 206. Actuation bar moves upon amovement of lock button 282. In operation, in order to lock the positionand/or orientation of distal drive member 248, a user moves lock button282 from a distal position to a proximal position, thereby causing thelock out (not shown) to move proximally such that a distal face of thelock out moves out of contact with camming member 288, which causescamming member 288 to cam into recess 249 of distal drive member 248. Inthis manner, distal drive member 248 is prevented from distal and/orproximal movement. When lock button 282 is moved from the proximalposition to the distal position, the distal end of actuation bar movesdistally into the lock out (not shown), against the bias of a biasingmember (not shown), to force camming member 288 out of recess 249,thereby allowing unimpeded axial translation and radial movement ofdistal drive member 248.

Returning again to FIG. 6, adapter 200 includes an electrical assembly290 supported on and in outer knob housing 202 and inner housingassembly 204. Electrical assembly 290 includes a plurality of electricalcontact blades 292, supported on a circuit board 294, for electricalconnection to pass-through connector of plate assembly of shell housing10 of surgical instrument 100. Electrical assembly 290 serves to allowfor calibration and communication information (i.e., life-cycleinformation, system information, force information) to pass to thecircuit board of surgical instrument 100 via an electrical receptacleportion of the power-pack core assembly 106 of surgical instrument 100.Electrical assembly 290 further includes a strain gauge 296 that iselectrically connected to circuit board 294. Strain gauge 296 is mountedwithin the inner housing assembly 204 to restrict rotation of the straingauge 296 relative thereto. First rotatable proximal drive shaft 212extends through strain gauge 296 to enable the strain gauge 296 toprovide a closed-loop feedback to a firing/clamping load exhibited byfirst rotatable proximal drive shaft 212. Electrical assembly 290 alsoincludes a slip ring 298 that is non-rotatably and slidably disposedalong drive coupling nut 244 of outer tube 206. Slip ring 298 is inelectrical connection with circuit board 294 and serves to permitrotation of first rotatable proximal drive shaft 212 and axialtranslation of drive coupling nut 244 while still maintaining electricalcontact of slip ring 298 with at least another electrical componentwithin adapter 200, and while permitting the other electrical componentsto rotate about first rotatable proximal drive shaft 212 and drivecoupling nut 244.

Still referring to FIG. 6, inner housing assembly 204 includes a hub 205that has a distally oriented annular wall 207 that defines asubstantially circular outer profile. Hub 205 includes a substantiallytear-drop shaped inner recess or bore that is shaped and dimensioned toslidably receive articulation bearing assembly 252 therewithin. Innerhousing assembly 204 further includes a ring plate 254 that is securedto a distal face of distally oriented annular wall 207 of hub 204 a.Ring plate 254 defines an aperture 254 a therethrough that is sized andformed therein so as to be aligned with second proximal drive shaft 214and to rotatably receive a distal tip thereof. In this manner, thedistal tip of the second proximal drive shaft 214 is supported andprevented from moving radially away from a longitudinal rotational axisof second proximal drive shaft 214 as second proximal drive shaft 214 isrotated to axially translate articulation bearing assembly 252.

Turning next to FIG. 10, in one example, the end effector 500 may beconfigured for a single use (“disposable loading unit—DLU”) and besimilar to those DLU's disclosed in U.S. Patent Application PublicationNo. 2010/0301097, entitled LOADING UNIT HAVING DRIVE ASSEMBLY LOCKINGMECHANISM, now U.S. Pat. No. 9,795,384, U.S. Patent ApplicationPublication No. 2012/0217284, entitled LOCKING MECHANISM FOR USE WITHLOADING UNITS, now U.S. Pat. No. 8,292,158, and U.S. Patent ApplicationPublication No. 2015/0374371, entitled ADAPTER ASSEMBLIES FORINTERCONNECTING SURGICAL LOADING UNITS AND HANDLE ASSEMBLIES, the entiredisclosures of each such references being hereby incorporated byreference herein. It is also contemplated that the end effector 500 maybe configured for multiple uses (MULU) such as those end effectorsdisclosed in U.S. Patent Application Publication No. 2017/0095250,entitled MULTI-USE LOADING UNIT, the entire disclosure of which ishereby incorporated by reference herein.

The depicted surgical instrument 100 fires staples, but it may beadapted to fire any other suitable fastener such as clips and two-partfasteners. In the illustrated arrangement, the end effector 500comprises a loading unit 510. The loading unit 510 comprises a proximalbody portion 520 and a tool assembly 600. Tool assembly 600 includes apair of jaw members including a first jaw member 610 that comprises ananvil assembly 612 and a second jaw member 700 that comprises acartridge assembly 701. One jaw member is pivotal in relation to theother to enable the clamping of tissue between the jaw members. Thecartridge assembly 701 is movable in relation to anvil assembly 612 andis movable between an open or unclamped position and a closed orapproximated position. However, the anvil assembly 612, or both thecartridge assembly 701 and the anvil assembly 612, can be movable.

The cartridge assembly 701 has a cartridge body 702 and in someinstances a support plate 710 that are attached to a channel 720 by asnap-fit connection, a detent, latch, or by another type of connection.The cartridge assembly 701 includes fasteners or staples 704 that aremovably supported in a plurality of laterally spaced staple retentionslots 706, which are configured as openings in a tissue contactingsurface 708. Each slot 706 is configured to receive a fastener or stapletherein. Cartridge body 702 also defines a plurality of cam wedge slotswhich accommodate staple pushers 709 and which are open on the bottom(i.e., away from tissue-contacting surface) to allow an actuation sled712 to pass longitudinally therethrough. The cartridge assembly 701 isremovable from channel 720 after the staples have been fired fromcartridge body 702. Another removable cartridge assembly is capable ofbeing loaded onto channel 720, such that surgical instrument 100 can beactuated again to fire additional fasteners or staples. Further detailsconcerning the cartridge assembly may be found, for example, in U.S.Patent Application Publication No. 2017/0095250 as well as various otherreferences that have been incorporated by reference herein.

Cartridge assembly 701 is pivotal in relation to anvil assembly 612 andis movable between an open or unclamped position and a closed or clampedposition for insertion through a cannula of a trocar. Proximal bodyportion 520 includes at least a drive assembly 540 and an articulationlink 560. In one arrangement, drive assembly 540 includes a flexibledrive beam 542 that has a distal end 544 and a proximal engagementsection 546. A proximal end of the engagement section 546 includesdiametrically opposed inwardly extending fingers 547 that engage ahollow drive member 548 to fixedly secure drive member 548 to theproximal end of beam 542. Drive member 548 defines a proximal portholewhich receives connection member 247 of drive tube 246 of first driveconverting assembly 240 of adapter 200 when the end effector 500 isattached to the distal end of the adapter 200.

End effector 500 further includes a housing assembly 530 that comprisesan outer housing 532 and an inner housing 534 that is disposed withinouter housing 532. First and second lugs 536 are each disposed on anouter surface of a proximal end 533 of outer housing 532 and areconfigured to operably engage the distal end of the adapter 200 asdiscussed in further detail in WO 2016/057225 A1.

With reference to FIG. 10, for example, anvil assembly 612 includes ananvil cover 630 and an anvil plate 620, which includes a plurality ofstaple forming depressions. Anvil plate 620 is secured to an undersideof anvil cover 630. When tool assembly 600 is in the approximatedposition, staple forming depressions are positioned in juxtaposedalignment with staple receiving slots of the cartridge assembly 701.

The tool assembly 600 includes a mounting assembly 800 that comprises anupper mounting portion 810 and a lower mounting portion 812. A mountingtail 632 protrudes proximally from a proximal end 631 of the anvil cover630. A centrally-located pivot member 814 extends from each upper andlower mounting portions 810 and 812 through openings 822 that are formedin coupling members 820. In at least one arrangement, the pivot member814 of the upper mounting portion 810 also extends through an opening634 in the mounting tail 632 as well. Coupling members 820 each includean interlocking proximal portion 824 that is configured to be receivedin corresponding grooves formed in distal ends of the outer housing 532and inner housing 534. Proximal body portion 520 of end effector 500includes articulation link 560 that has a hooked proximal end 562. Thearticulation link 560 is dimensioned to be slidably positioned within aslot in the inner housing. A pair of H-block assemblies 830 arepositioned adjacent the distal end of the outer housing 532 and adjacentthe distal end 544 of axial drive assembly 540 to prevent outwardbuckling and bulging of the flexible drive beam 542 during articulationand firing of surgical stapling apparatus 10. Each H-block assembly 830includes a flexible body 832 which includes a proximal end fixedlysecured to the distal end of the outer housing 532 and a distal end thatis fixedly secured to mounting assembly 800. In one arrangement, adistal end 564 of the articulation link is pivotally pinned to the rightH block assembly 830. Axial movement of the articulation link 560 willcause the tool assembly to articulate relative to the body portion 520.

FIGS. 11-15 illustrate an adapter 200′ that is substantially identicalto adapter 200 described above, except for the differences noted below.As can be seen in FIG. 11, the adapter 200′ includes an outer tube 206that has a proximal end portion 910 that has a first diameter “FD” andis mounted within the outer knob housing 202. The proximal end portion910 may be coupled to the inner housing assembly 204 or otherwisesupported therein in the manners discussed in further detail in WO2016/057225 A1 for example. The proximal end portion 910 extendsproximally from a central tube portion 912 that has a second diameter“SD”. In the illustrated embodiment, an end effector 500 is coupled to adistal end 914 of a shaft assembly 203 or outer tube 206. The outer tube206 defines a longitudinal axis LA that extends between the proximal endportion 910 and the distal end 914 as can be seen in FIG. 11. As can beseen in FIGS. 10 and 11, an outer sleeve 570 of the proximal bodyportion 520 of the end effector 500 has a distal end portion 572 and aproximal end portion 574. The proximal end portion 574 has a diameterSD′ that is approximately equal to the second diameter SD of the centraltube portion 912. The distal end portion 572 has a third diameter “TD”.In one arrangement, FD and TD are approximately equal and greater thanSD. Other arrangements are contemplated wherein FD and TD are not equal,but each are greater than SD. However, it is preferable that for mostcases FD and TD are dimensioned for endoscopic insertion through atypical trocar port, cannula or the like. In at least one arrangement(FIG. 11), the outer sleeve 570 is formed with a flat or scalloped side576 to facilitate improved access within the patient while effectivelyaccommodating the various drive and articulation components of theadapter 200′. In addition, by providing the central tube portion 912with a reduced diameter may afford the adapter 200′ with improvedthoracic in-between rib access.

In at least one arrangement, channel 720, which may be machined or madeof sheet metal, includes a pair of proximal holes 722 (FIG. 10) that areconfigured to align with a pair of corresponding holes 636 in the anvilcover 630 to receive corresponding pins or bosses 638 (FIG. 12) tofacilitate a pivotal relationship between anvil assembly 612 andcartridge assembly 701. In the illustrated example, a dynamic clampingassembly 550 is attached to or formed at the distal end 544 of theflexible drive beam 542. The dynamic clamping assembly 550 includes avertical body portion 552 that has a tissue cutting surface 554 formedthereon or attached thereto. See FIG. 10, for example. An anvilengagement feature 556 is formed on one end of the body portion 552 andcomprises an anvil engagement tab 557 that protrudes from each lateralside of the body portion 552. Similarly, a channel engagement feature558 is formed on the other end of the of the body portion 552 andcomprises a channel engagement tab 559 that protrudes from each lateralside of the body portion 552. See FIG. 15.

As indicated above, the anvil assembly 612 includes an anvil plate 620.The anvil plate 620 includes an elongate slot 622 that is configured toaccommodate the body portion 552 of the dynamic clamping assembly 550 asthe dynamic clamping assembly 550 is axially advanced during the firingprocess. The elongate slot 622 is defined between two anvil plate ledges624 that extend along each lateral side of the elongate slot 622. SeeFIG. 10. As the dynamic clamping assembly 550 is distally advanced, theanvil engagement tabs 557 slidably engage the anvil plate ledges 624 toretain the anvil assembly 612 clamped onto the target tissue. Similarly,during the firing operation, the body portion 552 of the dynamicclamping assembly 550 extends through a central slot in the channel 720and the channel engagement tabs 559 slidably engage channel ledges 725extending along each side of the central channel slot to retain thecartridge assembly 701 clamped onto the target tissue.

Turning to FIGS. 13 and 15, the channel 720 defines a docking areagenerally designated as 730 that is configured to accommodate thedynamic clamping assembly 550 when it is in its proximal most positionreferred to herein as an unfired or starting position. In particular,the docking area 730 is partially defined by planar docking surfaces 732that provides clearance between the channel engagement tabs 559 on thedynamic clamping assembly 550 to enable the cartridge assembly 701 topivot to a fully opened position. A ramped or camming surface 726extends from a distal end of each of the docking surfaces 732. Rampedsurface 726 is engaged by the dynamic clamping assembly 550 in order tomove the anvil assembly 612 and the cartridge assembly 701 with respectto one another. Similar camming surface could be provided on the anvilassembly 612 in other embodiments. It is envisioned that ramped surfaces726 may also facilitate the alignment and/or engagement between channel720 and support plate 620 and/or cartridge body 702. As the driveassembly 540 is distally advanced (fired), the channel engagement tabs559 on the dynamic clamping assembly 550 engage the corresponding rampedsurfaces 726 to apply a closing motion to the cartridge assembly 701thus closing the cartridge assembly 701 and the anvil assembly 612.Further distal translation of the dynamic clamping assembly 550 causesthe actuation sled 712 to move distally through cartridge body 702,which causes cam wedges 713 of actuation sled 712 to sequentially engagestaple pushers 709 to move staple pushers 709 vertically within stapleretention slots 706 and eject staples 704 into staple formingdepressions of anvil plate 620. Subsequent to the ejection of staples704 from retention slots 706 (and into tissue), the cutting edge 554 ofthe dynamic clamping assembly 550 severs the stapled tissue as thetissue cutting edge 554 on the vertical body portion 552 of the dynamicclamping assembly 550 travels distally through a central slot 703 ofcartridge body 702. After staples 704 have been ejected from cartridgebody 702 and a user wishes to use the same instrument 10 to fireadditional staples 704 (or another type of fastener or knife), the usercan remove the loading unit 510 from the adapter 200′ and replace itwith another fresh or unspent loading unit. In an alternativearrangement, the user may simply remove the spent cartridge body 702 andreplace it with a fresh unspent or unfired cartridge body 702.

During use of conventional adapters, debris and body fluids can migrateinto the outer tube of the adapter and detrimentally hamper theoperation of the adapter articulation and firing drive systems. Inegregious cases, such debris and fluids infiltrate into the innerhousing assembly of the adapter which may cause the electricalcomponents supported therein to short out and malfunction. Further, dueto limited access to the interior of the outer tube of the adapter, suchdebris and fluids are difficult to remove therefrom which can prevent orreduce the ability to reuse the adapter.

Turning to FIGS. 16 and 17, in one arrangement, at least one first seal230 is provided between the proximal inner housing assembly 204 and thefirst rotatable proximal drive shaft 212 to prevent fluid/debrisinfiltration within and proximal to the proximal inner housing assembly204. In addition, at least one second seal 232 is provided between thearticulation bar 258 and the outer tube 206 to prevent fluid/debris frompassing therebetween to enter the proximal inner housing assembly 204.At least one third housing seal 233 may be provided around a hub 205 ofthe proximal inner housing 204 to establish a seal between the hub 205and the outer knob housing 202. The first, second, and third seals 230,232, 233 may comprise, for example, flexible O-rings manufactured fromrubber or other suitable material.

In other arrangements, it may be desirable for the first and secondseals 230, 232 to be located in the adapter 200 distal to the electroniccomponents housed within the outer knob housing 202. For example, toprevent fluids/debris from fouling/shorting the slip ring assembly 298,it is desirable establish seals between the various moving components ofthe adapter 200 that are operably supported within the outer tube 206 ina location or locations that are each distal to the slip ring assembly298, for example. The seals 230, 232 may be supported in the wall of theouter tube and/or in mounting member 234 or other separate mountingmember/bushing/housing supported within the outer tube 206 andconfigured to facilitate axial movement of the distal drive member 248as well as the articulation bar 258 while establishing a fluid-tightseal between the bushing and/or outer tube and the distal drive member248 and the articulation bar 258. See FIGS. 18 and 20. In the embodimentillustrated in FIG. 19 for example, the first seal 230 may additionallyhave wiper features 231 that also slidably engage the distal drivemember 248 to prevent fluid/debris D from infiltrating in the proximaldirection PD into the proximal inner housing assembly 204. In at leastone arrangement to enable debris and fluids that have collected in theouter tube 206 distal to the first and second seals 230, 232, at leasttwo flushing ports 236, 238 are provided within the outer tube 206. Seee.g., FIGS. 18 and 20. The axially spaced flushing ports 236, 238 arelocated distal to the first and second seals 230, 232. A flushingsolution (e.g., cleaning fluid, saline fluid, air, etc.) may be enteredinto one or more port(s) to force the errant debris and fluid out of oneor more other port(s).

FIGS. 22-25 illustrate an end effector 4500 that may be used inconnection with the various adapter arrangements described herein. In onarrangement, the end effector 4500 comprises a first jaw 4610 in theform of an anvil assembly 4612. The anvil assembly 4612 comprises aproximal end portion 4614 and a distal end portion 4616 that define afirst longitudinal jaw axis or an anvil axis AA. The anvil assembly 4612further comprises a first jaw surface or anvil surface 4618 that mayinclude staple forming pockets (not shown) therein. In at least onearrangement, the anvil surface 4618 is approximately parallel to theanvil axis AA.

Still referring to FIGS. 22-25, the end effector 4500 further comprise asecond jaw 4700 that comprises a cartridge assembly 4701. In at leastone example, the cartridge assembly 4701 comprises a channel 4720 thatis configured to operably support a staple cartridge 4702 therein. Thechannel 4720 comprises a proximal channel end portion 4722 and a distalchannel end portion 4724 that defines a second longitudinal jaw axis orlongitudinal channel axis CA. The proximal end portion 4722 is pivotallypinned or otherwise pivotally coupled to the proximal end portion 4614of the anvil assembly 4612. The staple cartridge 4702 comprises acartridge proximal end portion 4704 and a cartridge distal end portion4706 and includes a cartridge deck surface 4708 that faces the anvilsurface 4618. The cartridge assembly 4701 and anvil assembly 4612 areselectively pivotable between a fully open position shown in FIG. 22 toa closed position (FIG. 23) to a fully closed position (FIG. 24) by adynamic clamping assembly 4550.

FIGS. 22-25 illustrate one form of a dynamic clamping assembly 4550 thatcomprises a vertical body portion 4552 that has a tissue cutting surface4554 formed thereon or attached thereto. An anvil engagement feature4556 is formed on one end of the body portion 4552 and comprises ananvil engagement tab 4557 that protrudes from each lateral side of thebody portion 4552. Similarly, a channel engagement feature 4558 isformed on the other end of the of the body portion 4552 and comprises achannel engagement tab 4559 that protrudes from each lateral side of thebody portion 4552. As can be seen in FIG. 25, the body portion 4552 isattached to or formed at a distal end of a flexible drive beam 4542 thatis operated in the various manners described above.

FIG. 22 illustrates the jaws 4610, 4700 in a fully open position. Whenin that position, the dynamic clamping assembly 4550 is in a parkingarea 4580 defined adjacent the proximal end portion 4704 of thecartridge assembly 4701 as well as the proximal channel end portion 4722and the proximal end portion 4614 of the anvil assembly 4612. When in astarting position in the parking area 4580, the channel engagementfeatures 4758 may not engage the channel and the anvil engagementfeatures may not engage the anvil assembly 4612. The anvil assembly 4612is formed with a pair of longitudinally extending anvil ledges 4620 thatare spaced from each other by an elongate anvil slot (not shown) that isconfigured to receive a portion of the body portion 4552 of the dynamicclamping assembly 4550 to extend therethrough. The anvil ledges 4620 areconfigured to be slidably engaged by the anvil engagement tabs 4557 onthe dynamic clamping assembly 4550 as the dynamic clamping assembly 4550is driven in the distal direction DD through the end effector 4500.Likewise, the proximal channel end portion 4722 comprises a cam surfaceor ramp arrangement 4730 that is configured to be initially engaged bythe channel engagement tabs 4559 on the dynamic clamping assembly 4550as the dynamic clamping assembly 4550 is initially moved distally fromthe starting position. The channel 4720 is formed with a pair oflongitudinally extending channel ledges 4732 that are configured to beslidably engaged by the channel engagement tabs 4559 as the dynamicclamping assembly is driven from the starting position to endingposition.

In one arrangement, the cam surface arrangement 4730 is configured suchthat upon initial engagement of the channel engagement tabs 4559therewith, the cartridge assembly 4701 and anvil assembly 4612 arepivoted to a fully closed position wherein the cartridge distal endportion 4706 actually contacts the distal end portion 4616 of the anvilassembly 4612. Such arrangement may be useful when manipulating thetarget tissue and/or adjacent tissue prior to clamping the target tissuebetween the jaws. The clinician can move the dynamic clamping assemblyto the initial closure position wherein the cam surface arrangement 4730is initially engaged by the channel engagement tabs 4559 to bring thedistal end portions 4706 and 4616 together to grasp and manipulatetissue.

Once the target tissue has been located between the anvil surface 4618and the cartridge deck surface 4708, the dynamic clamping assembly ismoved distally through the surgical end effector 4500. As the dynamicclamping assembly 4550 moves distally, the clamped tissue applies anopening force or forces to the anvil 4612 and cartridge assembly 4701which must be overcome by the dynamic clamping assembly 4550 as it movesdistally. These forces increase the amounts of frictional forces thatare generated between the anvil engagement tabs 4557 and the anvilledges 4620 and the channel engagement tabs 4559 and the channel ledges4732. In one arrangement, as can be seen in FIG. 22, the channel ledges4732 each include an upper ledge surface 4733 that is engaged by acorresponding one of the channel engagement tabs 4559. The channelledges 4732 are oriented at an angle such that a proximal end 4735 ofeach of the channel ledges 4732 is spaced from the cartridge decksurface 4708 a first distance D₁ and a distal end 4737 of each of thechannel ledges 4732 is spaced from the cartridge deck surface 4708 asecond distance D₂ wherein D₂>D₁. FIG. 23 illustrates the jaws 4600,4700 in a closed position wherein the distal end 4706 of the cartridge4702 is still spaced from the distal end 4616 of the anvil assembly 4612(the cartridge deck surface 4708 and the anvil surface 4618 are spacedfrom each other, but approximately parallel to each other). When in thatposition, the upper ledge surface 4733 is angled (approximately0.5°-2.0°, for example) relative to a longitudinal axis LA. FIGS. 24 and25 illustrate the jaws 4610, 4700 in a fully closed position (the distalend 4706 of the cartridge 4702 is in contact with the distal end 4616 ofthe anvil assembly 4612). When in that configuration, the upper ledgesurface 4733 is approximately parallel to the longitudinal axis LA. Sucharrangement can reduce the amount of frictional resistance experiencedby the dynamic clamping assembly 4550 as the dynamic clamping assembly4550 is driven distally (direction DD) through a firing stroke whereinthe dynamic clamping assembly 4550 not only retains the jaws 4600, 4700clamped onto the target tissue, but cuts the target tissue and fires thestaples operably supported in the staple cartridge 4702 through the cuttissue.

EXAMPLES Example 1

An end effector for use with a surgical instrument. In at least oneexample, the end effector comprises a first jaw that defines a first jawlongitudinal axis that extends between a first jaw proximal end and afirst jaw distal end and includes a first jaw surface. A second jaw ispivotally coupled to the first jaw such that the first jaw and thesecond jaw are movable relative to each other between a fully openposition and closed positions. The second jaw defines a second jawlongitudinal axis that extends between a second jaw proximal end and asecond jaw distal end and includes a second jaw face that faces thefirst jaw surface. The end effector further comprises a dynamic clampingassembly that includes first jaw engagement features and second jawengagement features. The dynamic clamping assembly is axially movablefrom a starting position wherein the first and second jaws are in thefully open position and an ending position adjacent the first jaw distalend and the second jaw distal end. The second jaw further has a camsurface arrangement thereon that is configured for camming engagementwith the second jaw engagement features on the dynamic clamping assemblywhen the dynamic clamping assembly is moved from the starting positiontoward the ending position such that initial engagement of the secondjaw engagement features with the cam surface arrangement causes thesecond jaw to pivot to an initial closed position wherein the second jawdistal end contacts the first jaw distal end.

Example 2

The end effector of Example 1, wherein the second jaw comprises a secondjaw ledge that corresponds to each second jaw engagement feature on thedynamic clamping assembly for sliding engagement therewith as thedynamic clamping assembly is driven from the starting position to theending position.

Example 3

The end effector of Example 2, wherein each second jaw ledge comprises asecond jaw engagement surface that is oriented at an angle with respectto the second jaw face.

Example 4

The end effector of Examples 2 or 3, wherein each second jaw ledgeextends between a second ledge proximal end that is spaced from thesecond jaw face a first distance and a second ledge distal end spacedfrom the second jaw face a second distance that is greater than thefirst distance.

Example 5

The end effector of Examples 1, 2, 3 or 4, wherein the dynamic clampingassembly comprises a tissue cutting surface.

Example 6

The end effector of Examples 1, 2, 3, 4 or 5, wherein the first jawcomprises an anvil and wherein the second jaw comprises a cartridgeassembly.

Example 7

The end effector of Example 6, wherein the cartridge assembly comprisesa channel that is pivotally coupled to the anvil and is configured tooperably support a cartridge therein. The cam surface is on the channeland the second jaw surface is on a cartridge supported in the channel.

Example 8

The end effector of Examples 1, 2, 3, 4, 5, 6 or 7, wherein the dynamicclamping assembly comprises a vertically extending body portion andwherein the first jaw engagement features comprise first flanges thatlaterally extend from the vertically extending body and wherein thesecond jaw engagement features comprise second flanges that laterallyextend from the vertically extending body portion and are spaced fromthe first flanges.

Example 9

The end effector of Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the endeffector is operably coupled to a proximal housing portion that isconfigured to be releasably coupled to a shaft assembly of an adapterthat is configured to be operably coupled to the surgical instrument.

Example 10

An end effector for use with an adapter that is configured for use withan electromechanical surgical instrument. In at least one example, theend effector comprises an anvil that defines an anvil longitudinal axisthat extends between a proximal anvil end and a distal anvil end. Theend effector further comprises a cartridge assembly that defines acartridge assembly longitudinal axis that extends between a proximalcartridge assembly end and a distal cartridge assembly end. The proximalcartridge assembly end is pivotally coupled to the proximal anvil endsuch that the anvil and the cartridge assembly are movable relative toeach other between a fully open position and closed positions. The endeffector further comprises means for applying opening and closingmotions to the anvil and cartridge assembly as the means is axiallydriven between a starting position wherein the means initially engagesthe cartridge assembly to move the cartridge assembly relative to theanvil such that the distal cartridge assembly end contacts the distalanvil end and an ending position that is adjacent to the distal ends ofthe anvil and cartridge assembly.

Example 11

The end effector of Example 10, wherein the cartridge assembly comprisesa channel that has a proximal channel end that is pivotally coupled tothe proximal anvil end and is configured to operably support a surgicalstaple cartridge therein.

Example 12

The end effector of Examples 10 or 11, wherein the means for applyingopening and closing motions comprises a dynamic clamping assembly. In atleast one example, the dynamic clamping assembly comprises a verticallyextending body portion that has a lateral anvil engagement flangeextending from each lateral side thereof. The lateral anvil engagementflanges are configured to engage the anvil. A lateral channel engagementflange extends from each lateral side of the vertically extending bodyand is spaced from the lateral anvil engagement flanges. Each lateralchannel engagement flange is configured to engage the channel.

Example 13

The end effector of Example 12, wherein the dynamic clamping assemblyincludes a tissue cutting surface.

Example 14

An end effector for use with a surgical instrument. In at least oneexample, the end effector comprises a proximal housing that isconfigured for operable attachment to the surgical instrument. A toolassembly is operably coupled to the proximal housing. In at least onearrangement, the tool assembly comprises an anvil that has a proximalanvil end and a distal anvil end. A pair of spaced anvil ledges extendsbetween the proximal anvil end and the distal anvil end. The toolassembly further comprises a cartridge assembly that includes a channelthat has a proximal channel end that is pivotally coupled to theproximal anvil end and is configured to operably support a surgicalstaple cartridge therein such that a cartridge deck surface of thesurgical staple cartridge faces the anvil. The channel further comprisesa pair of spaced channel ledges that extend from the proximal channelend to the distal channel end such that a proximal end of each of thechannel ledges is located a first distance from the cartridge decksurface. A distal end of each of the channel ledges is located a seconddistance from the cartridge deck surface. The second distance is greaterthan the first distance. The tool assembly further comprises a dynamicclamping assembly that has a vertically extending body portion that hasa lateral anvil engagement flange extending from each lateral sidethereof. Each lateral anvil engagement flange is configured to engage acorresponding anvil ledge. A lateral channel engagement flange extendsfrom each lateral side of the vertically extending body and isconfigured to engage a corresponding channel ledge.

Example 15

The end effector of Example 14, wherein the dynamic clamping assemblycomprises a tissue cutting surface.

Example 16

The end effector of Examples 14 or 15, wherein the spaced channel ledgesare separated by an elongate channel slot that is configured to receivea portion of the vertically extending body portion therethrough.

Example 17

The end effector of Examples 14, 15 or 16, wherein the spaced anvilledges are separated by an elongate anvil slot that is configured toreceive a portion of the vertically extending body portion therein.

Many of the surgical instrument systems described herein are motivatedby an electric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In various instances,the surgical instrument systems described herein can be motivated by amanually-operated trigger, for example. In certain instances, the motorsdisclosed herein may comprise a portion or portions of a roboticallycontrolled system. Moreover, any of the end effectors and/or toolassemblies disclosed herein can be utilized with a robotic surgicalinstrument system. U.S. patent application Ser. No. 13/118,241, entitledSURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, disclosesseveral examples of a robotic surgical instrument system in greaterdetail.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one oremore other embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

What is claimed is:
 1. An end effector for use with a surgicalinstrument, wherein said end effector comprises: a first jaw comprising:a first jaw proximal end; a first jaw distal end; and a first jaw faceextending between said first jaw proximal end and said first jaw distalend, and wherein said end effector further comprises: a second jawcomprising: a second jaw proximal end; a second jaw distal end; a secondjaw face extending between said second jaw proximal end and said secondjaw distal end, wherein said second jaw proximal end is pivotallycoupled to said first jaw proximal end such that said second jaw ismovable relative to said first jaw between a fully open position, aclosed position, and a fully closed position in which said second jawface is not parallel with said first jaw face and said second jaw distalend is in contact with said first jaw distal end; a closure cam surfaceon said second jaw proximal end; and at least one second jaw ledge, andwherein said end effector further comprises: a dynamic clamping assemblycomprising at least one first jaw engagement feature and at least onesecond jaw engagement feature, wherein said dynamic clamping assembly isaxially movable between a starting position in which said first jaw andsaid second jaw are in said fully open position and an ending positionin which said dynamic clamping assembly is adjacent said first jawdistal end and said second jaw distal end, wherein engagement of said atleast one second jaw engagement feature with a proximal end of said atleast one second jaw ledge on said second jaw pivots said second jaw tosaid closed position and engagement of said at least one second jawengagement feature with said closure cam surface moves said second jawto said fully closed position; and wherein said second jaw furthercomprises: a first distance between said second jaw ledge and saidsecond jaw face at said second jaw proximal end; and a second distancebetween said second jaw ledge and said second jaw face at said distalend, wherein said second distance differs from said first distance. 2.The end effector of claim 1, wherein each said second jaw ledgecomprises a second jaw engagement surface that is oriented at an anglewith respect to said second jaw face.
 3. The end effector of claim 2,wherein each said second jaw ledge extends between said proximal endthereof that is spaced from said second jaw face a first distance and asecond ledge distal end spaced from said second jaw face a seconddistance that is greater than said first distance.
 4. The end effectorof claim 1, wherein said dynamic clamping assembly comprises a tissuecutting surface.
 5. The end effector of claim 1, wherein said first jawcomprises an anvil and wherein said second jaw comprises a cartridgeassembly.
 6. The end effector of claim 5, wherein said cartridgeassembly comprises a channel pivotally coupled to said anvil andconfigured to operably support a cartridge therein, and wherein saidclosure cam surface is on said channel and said second jaw face is on acartridge supported in said channel.
 7. The end effector of claim 1,wherein said dynamic clamping assembly comprises a vertically extendingbody portion, wherein said at least one first jaw engagement featurecomprises a first flange laterally extending from each side of saidvertically extending body portion, and wherein said at least one secondjaw engagement feature comprises a second flange laterally extendingfrom each said side of said vertically extending body portion and spacedfrom said first flanges.
 8. The end effector of claim 6, wherein saidend effector is operably coupled to a proximal housing portionconfigured to be releasably coupled to a shaft assembly of an adapterconfigured to be operably coupled to the surgical instrument.
 9. The endeffector of claim 1, wherein said second distance is greater than saidfirst distance.
 10. A disposable loading unit for use with a surgicalinstrument, wherein said disposable loading unit comprises: an anvilcomprising: an anvil proximal end; an anvil distal end; a pair of anvilledges extending between said anvil proximal end and said anvil distalend; and a staple forming surface extending between said anvil proximalend and said anvil distal end, and wherein said disposable loading unitfurther comprises: a channel supported for pivotal travel relative tosaid anvil proximal end, wherein said channel comprises a closure camsurface and a pair of channel ledges; a surgical staple cartridgesupported in said channel, wherein said surgical staple cartridgecomprises a cartridge body, wherein said cartridge body comprises acartridge proximal end and a cartridge distal end, wherein a cartridgedeck surface extends between said cartridge distal end and saidcartridge proximal end and faces said staple forming surface of saidanvil, and wherein said channel is pivotable relative to said anvilbetween a fully open position, a closed position, and a fully closedposition wherein said cartridge deck surface is not parallel with saidstaple forming surface and said cartridge distal end is in contact withsaid anvil distal end and each of said channel ledges are parallel withsaid anvil ledges; and a dynamic clamping assembly comprising: an anvilengagement flange; and a channel engagement flange, wherein said dynamicclamping assembly is axially movable between a starting position whereinsaid channel is in said fully open position and an ending positionwherein said dynamic clamping assembly is adjacent to said anvil distalend and said cartridge distal end, and wherein as said dynamic clampingassembly is moved distally from said starting position, said channelengagement flange engages said closure cam surface to pivot said channelto said fully closed position, and wherein said disposable loading unitfurther comprises: a first distance between said channel ledged and saidcartridge deck surface at said cartridge proximal end; and a seconddistance between said channel ledges and said cartridge deck surface atsaid cartridge distal end, wherein said second distance differs fromsaid first distance.
 11. The disposable loading unit of claim 10,wherein said second distance is greater than said first distance.